Health?chiefs are urging drinkers to take it easy when pubs reopen on "Super Saturday" amid fears that Accident and Emergency units could end up overwhelmed.
Pubs, restaurants and bars are allowed to reopen for business this weekend following their closure since the UK coronavirus lockdown began in March.
But medics are fearful that hospitals could be deluged by those who overdo their celebrations and warned that A&E units, which have been largely free of drunk and disorderly patients during lockdown, can now only cope with about half their usual capacity.
In recent months, casualty departments have been redesigned?to segregate groups of patients?and allow the screening of new arrivals.?Doctors said this meant they could be less able to cope with sudden spikes in demand?– which they fear could occur this weekend.?
Dr Katherine Henderson, the president of the College of Emergency Medicine, said: "We are nervous. We are bracing ourselves for this weekend. We do understand that people want to celebrate, but we've got to do this carefully. It is slightly scary for the NHS."?
Police chiefs have criticised the decision to lift the lockdown at the weekend, saying the build-up to July 4 has created a "countdown to carnival" which is likely to fuel drunken and irresponsible behaviour.?
Dr Henderson said hospital workers were "exhausted" and fearful of what "Super Saturday" may bring, adding: "Staff have been working very hard for a long time.
"If they see a lot of people who have thrown caution to the wind, getting themselves into danger, getting themselves into fights, that is going to be really difficult.?
"We need people to apply common sense?– don't get yourself so drunk you can't get yourself home."
She added that many A&E departments will bring in extra staff for this weekend after a period in which admissions have been low (see below).?
Dr Cliff Mann, NHS England's national clinical director for urgent and emergency care, urged the public to behave responsibly but said the service was braced for spikes in demand.
"There are some A&Es where 75 per cent of attendances after 11pm are alcohol related, and?we would be naive to think we won't see some of that again," he said.?
He suggested hospitals will not tolerate rowdy behaviour, or attendance by those who do not need to be there, adding: "If they don't have?an acute injury or emergency, we will be inviting them to leave. We expect hospitals to make sure their security is fully briefed."
Dr Mann said it would not be safe for A&Es to return to the kind of occupancy levels which had been tolerated before Covid, as it did not allow social distancing, adding: "We can't have people crowding in A&E in the same way we can't have them crowding in M&S."?
Dr Simon Walsh, the British Medical Association's emergency medicine lead, said: "We've had to dramatically change the layouts of our A&E departments in order to segregate patients, so that means they can take about half as many people, in some cases less than that.
"We used to see A&E departments full of people with alcohol-related injuries, but we just don't have the space to look after these patients on top of others with medical emergencies, and Covid patients.?We know most people are relieved that pubs are open, but we do need everyone to take responsibility for their actions."
Dr Nick Scriven, the immediate past president of the Society for Acute Medicine, said recent scenes of brawls in Liverpool, Bournemouth and London, even before pubs had reopened, had added to medics' concerns.?
"The worry is that we see a sudden return to all the things that A&Es have seen so much less of in the last three months; the violence and injuries caused by drinking," he said. "There is real anxiety about what will happen this weekend."?